Chapters authored
Obese Childhood Dyslipidemia Management Beyond Statins — MUFA, PUFA, and Sea-buckthorn Supplements
The dyslipidemia pattern usually associated with childhood obesity consists of a combination of elevated triglyceridemia, decreased plasma high density lipoprotein cholesterol concentration and LDL-c concentration at the upper limit of the normal range. This type of dyslipidemia is associated with dense and small LDL, which are proatherogenic. High circulating levels of oxidized LDL were described in extreme pediatric obesity, in children with high fructose intake and are associated with insulin resistance. The worst effect on blood lipids have trans and saturated fatty acids. But the amount of total energy intake plays more important role in lipid profiles. In childhood obesity it seems that insulin resistance precedes the development of the metabolic syndrome feature and insulin resistance is correlated with dyslipidemia. Insulin resistance increases free fatty acid flux to the liver by decreased inhibition of lipolysis and also by increased de novo lipogenesis. Fish oil is rich in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and has hypotriglyceridemic effect in comparison to monounsaturated fatty acids. Passive in utero exposure to a hyperlipidemic environment may have programmed these children for accelerated atherosclerosis. The infant formula should be enriched with long chain fatty acids because this supplementation is associated with lower blood pressure during later childhood. In obese children, supplements with Omega-3 polyunsaturated fatty acids improve lipid profile, blood pressure values and inflammatory markers. Omega-3 fatty acids prevent metabolic syndrome, by reducing hepatic steatosis, visceral fat, by reducing serum triglycerides and improving insulin sensitivity. Potentially all compounds of the Sea buckthorn berry, including flavonols, carotenoids, fatty acids, tocopherols and phytosterols can affect the metabolic profile. Special features of the berry oils are high proportions of palmitoleic acid as well as vitamin E, carotenoids, and sterols. The palmitoleic acid stimulates muscle insulin action, suppresses hepatosteatosis and prevent the deleterious effects of saturated fatty acids and high glucose on human pancreatic beta-cell turnover and function. Phenolic compounds and flavonoids from sea buckthorn ameliorate bodyweight, blood glucose, and serum lipid profile. By reducing triglyceridemia and by improving the blood pressure levels, sea buckthorn pulp oil may prevent metabolic syndrome in obese children. The treatment is recommended in hypertriglyceridemic waist phenotype obese children. Omega-3 supplements and sea buckthorn pulp oil supplements reversed the carotid intima media thickness values in obese children and they have beneficial effects in childhood obesity
Part of the book: Lipoproteins